HIMSS G7 Report Offers Insights on Five Areas of Risk for ICD-10 Conversion

With the ICD-10 conversion deadline of October 1, 2013, healthcare providers must address areas of risk involved in planning and implementing ICD-10 to avoid catastrophic consequences, according to the new HIMSS G7 report, ICD-10 Transformation:  Five Critical Risk Mitigation Strategies. This is the second G7 advisory report focused on ICD-10, with the first issued in spring 2011: HIMSS G7 Advisory Report:  ICD-10 PlayBook.

The latest HIMSS G7 Advisory Report—now available on HIMSS website looks at real-life issues of ICD-10 implementation in the context of the healthcare economy, competing federal mandates and limited resources.  This report identifies five areas of risk healthcare providers should address in their decision-making process for the ICD-10 transition.  These five areas are:’

1. Financial impacts and sustainability,
2. Work force,
3. Vendor readiness,
4. Provider payments, and
5. Fraud, waste and abuse.

In addition, the report includes specific tips for practice areas directly impacted by ICD-10:  small practices, larger practices, acute care hospitals, safety net entities and health plans.

“Our G7 Roundtable reviewed our first ICD-10 report and realized that we need more analysis and answers to questions surrounding the potential impact of claims rejections and delayed payments,  ” said John Casillas, Senior Vice President, HIMSS Business-Centered Systems.

As Casillas explained, hospitals can have between 100 -200 software systems and 30 different vendor partners that must be reviewed during the ICD-10 transition. “This report is designed to provide guidance for successful and timely implementation of ICD-10.”

HIMSS and some 30 different organizations developed the ICD-10 PlayBook in May 2011 with the second version of this free, online resource introduced in November 2011. Housed on the HIMSS website, theICD-10 PlayBook Version 2, includes VitalVendors, a voluntary, self-reported vendor readiness rating system powered by VitalWare.  As noted in the report, “This tool is helpful to providers since it allows visualization of available vendors with ICD-10 products and services in the event there is a need to add additional vendors to their current team.”

ICD-10 Transformation:  Five Critical Risk Mitigation Strategies provides guidelines from the HIMSS G7 to help providers avoid losses and cash collection delays during the ICD-10 implementation.  As noted in the report, “The transition to ICD-10 impacts all facets of the healthcare continuum. Successful outcomes of approaching this initiative proactively include:

• Increased efficiency in claims processing;
• Improved claims accuracy;
• Improved data capture for knowledge-based decision making; and
• Reduced unnecessary cash flow issues.”

“Healthcare providers must start now, if they haven’t done so, to implement ICD-10. While the level of impact for risk mitigation may vary depending on the size of the hospital, health system or medical practice, the commonalities exist, as noted in this report,” said Juliet A. Santos, MSN, CCRN, FNP-BC, Senior Director, Business-Centered Systems for HIMSS.  “Basically, each organization must protect its financial stability, and this depends on transitioning successfully to ICD-10 in less than 24 months to meet the upcoming deadline.”

Attend theICD-10 Symposium at the 2012 Annual HIMSS Conference & Exhibition in Las Vegas from Feb. 20-24, 2012.

Register for the Summit for Health Information and Financial Technology, held during HIMSS12.

Learn more about the HIMSS G7.  Sponsors of the HIMSS G7 are Kaiser Permanente, Lexis Nexus, Optum and Sentry Data Systems.

For more information on the HIMSS G7, Medical Banking Project or other Business-Centered Systems initiatives, contact John Casillas, senior vice president, Business-Centered Systems, at jcasillas@himss.org, or Juliet Santos, senior director, Business-Centered Systems, at jasantos@himss.org.


HIMSS is a cause-based, not-for-profit organization exclusively focused on providing global leadership for the optimal use of information technology (IT) and management systems for the betterment of healthcare. Founded 50 years ago, HIMSS and its related organizations are headquartered in Chicago with additional offices in the United States, Europe and Asia. HIMSS represents more than 38,000 individual members, of which more than two thirds work in healthcare provider, governmental and not-for-profit organizations. HIMSS also includes over 540 corporate members and more than 120 not-for-profit organizations that share our mission of transforming healthcare through the effective use of information technology and management systems. HIMSS frames and leads healthcare practices and public policy through its content expertise, professional development, research initiatives, and media vehicles designed to promote information and management systems’ contributions to improving the quality, safety, access, and cost-effectiveness of patient care. To learn more about HIMSS and to find out how to join us and our members in advancing our cause, please visit our website at www.himss.org.